Septic shock and severe sepsis represent a major public health problem in the United States, despite the development of increasingly powerful antibiotics and advanced forms of intensive care unit-based support modalities (see, e.g., Shanley, T. et al. Sepsis, 3rd Ed., St. Louis, Mo., Mosby (2006)). Worldwide, septic shock affects millions of adults, killing approximately one in four (see, e.g., Dellinger, R. et al. Crit. Care Med. 36:296-327 (2008)). A recent study suggests that the incidence and the mortality rates of septic shock in adults are increasing in the United States (Dombrovskiy, V. et al. Crit. Care Med. 35:1244-50 (2007)).
Reliably stratifying patients into those at low risk and those at high risk for poor outcomes is fundamental to effective clinical practice and clinical research (Marshall J. Leukoc. Biol. 83:471-82 (2008)). No reliable and widely accepted risk stratification tool specific for septic shock in adults has heretofore been developed. Such a tool would be beneficial at several levels, including better-informed decision making for individual patients (i.e. prognostication), as an adjustment or design variable in interventional clinical trials, and as a metric for quality improvement efforts.